Does colon cancer ever metastasize to bone first? a temporal analysis of colorectal cancer progression

• Type of Material: Article
• Authors: Eira S Roth, The University of Texas Medical School; David T Fetzer, The University of Texas Medical School; Bruce J Barron, Emory University; Usha A Joseph, The University of Texas Medical School; David Q Wan, The University of Texas Medical School
• Language: English
• Date: 2009
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: ©2009 Roth et al; licensee BioMed Central Ltd.
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://www.biomedcentral.com/1471-2407/9/274
• Title of Journal or Parent Work: BMC Cancer
• ISSN: 1471-2407
• Volume: 9
• Issue: 274
• Grant/Funding Information: This manuscript was edited by Tegra Rosera, MA, MS, and Maureen Goode, PhD, ELS, of The University of Texas Health Science Center at Houston Center for Clinical and Translational Sciences (supported by National Institutes of Health Clinical and Translational Science Award UL1 RR024148).
• Research Categories: Health Sciences, Oncology

Abstract

Background It is well recognized that colorectal cancer does not frequently metastasize to bone. The aim of this retrospective study was to establish whether colorectal cancer ever bypasses other organs and metastasizes directly to bone and whether the presence of lung lesions is superior to liver as a better predictor of the likelihood and timing of bone metastasis. Methods We performed a retrospective analysis on patients with a clinical diagnosis of colon cancer referred for staging using whole-body 18F-FDG PET and CT or PET/CT. We combined PET and CT reports from 252 individuals with information concerning patient history, other imaging modalities, and treatments to analyze disease progression. Results No patient had isolated osseous metastasis at the time of diagnosis, and none developed isolated bone metastasis without other organ involvement during our survey period. It took significantly longer for colorectal cancer patients to develop metastasis to the lungs (23.3 months) or to bone (21.2 months) than to the liver (9.8 months). Conclusion: Metastasis only to bone without other organ involvement in colorectal cancer patients is extremely rare, perhaps more rare than we previously thought. Our findings suggest that resistant metastasis to the lungs predicts potential disease progression to bone in the colorectal cancer population better than liver metastasis does.